Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 05424 | Date 14/02/2022 |
| Token No | SM/21-22/2148 14/02/2022 | Serial | 006 |
| Patient Name | Mr. SK RAJA | Contact No | NOT GIVEN |
| Address | MIAJAN DARJI LANE, MALLICKPARA | Age | 55 Male |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||